There has been a rapid growth of elder care institutions across major Chinese cities in recent years. This new development is in response to rising consumer demands for formal long-term care (LTC) for the elderly in China. Yet little is currently known about these institutions, their organization, structure, financing and residents'characteristics. Such basic information is essential to understand the social, cultural and market forces driving the development of formal elder care services. In this project, a team of experienced LTC researchers from the U.S. and China propose to study the recent developments in the institutional elder care sector in China. Building upon their expertise and experience studying the institutional LTC system in both the U.S. and China, the study team will develop a nursing home data collection instrument that can be readily used by others throughout the country. Using this instrument through structured surveys, systematic quantitative data at the facility-level on the organizational attributes and aggregated resident characteristics will be collected from a representative sample of elder care homes in two major cities in China: Tianjin and Nanjing. Focus group discussions will be conducted with facility administrators to insure adequacy of the survey instrument before it is finalized, and with elderly residents and their family members for a qualitative understanding of the cultural meanings of institutional care. Through a thorough study of the sampled elder care homes in each city, this project seeks to provide a comprehensive profile of their organizational and residents'characteristics. Insights gained from this study will enrich a theoretical understanding of traditional Chinese culture and family norms in the face of social changes in elder care. Research findings will also inform potential consumers of institutional LTC services and government agencies interested in policy making, planning and regulations in this area. This collaborative project is mutually beneficial and provides a great opportunity to strengthen the partnership relationship and promote intellectual exchanges among scholars from the participating U.S. and Chinese universities. In the long term, the study team plans to build on experiences and findings from this project to continue and expand this line of research in multiple cities or at the national level, which ultimately will contribute to shaping a viable LTC system to meet the impending demand of a fast aging population in China. This research will be done primarily in China in collaboration with Xinping Guan at Nankai University (in Tianjin) and with Xiaotian Feng at Nanjing University (in Nanjing), as an extension of NIH. PUBLIC HEALTH REVELANCE: China's population is aging rapidly and pressures are building to grow institutional long term care as a policy. This collaborative study will develop and test a survey of nursing homes in two Chinese cities to document the growth and character of such facilities in China.